The Mental Health Magazine

Mental Health

Letter from the Editors If you’re reading this, it’s the second-to-last last week of classes. You know what that means: Finals are upon us.

Self-care tips from the editors...........................3

No, we aren’t reminding you of this unfortunate reality because we want to add to your stress. We are bringing up finals because we want to explore another oftendreaded topic of conversation: mental health at Hopkins. As the Task Force on Student Mental Health and Well-Being reported last spring, it’s a serious issue.

Mood Disorders Center......4

But does that come as a surprise? Think about conversations you’ve had or overheard on campus, perhaps while studying in Brody, our current substitute for a student center. Too often do we hear students recounting how little sleep they’ve gotten. Too often do we hear students failing to remember the last time they had a real meal.

And too often do we see students striving for the perfect résumé or GPA at the expense of self-care.

We at The News-Letter hope that you can find strength in our stories. We hope that this magazine will help to break the stigma around discussing mental health and inspire future conversations about how we can improve it on campus. Because if you’re struggling with your mental health in this demanding environment, you are not alone. You are far from it.

— Rudy Malcom & Karen Wang Magazine Editors 2018-2019

A special to thanks to our sponsor:

A culture of excellence.......15 Meditation app review......16 Dealing with my OCD.......17

The science behind anxiety and depression....................5 My brother’s autism............18 The brain and your gut........19 Mental health and relationships........................6 But I can’t tell my story....20 Why I’m not going to forgive my abusers..............7 Mental health issues outside the bubble.........................21 Balancing mental health’s ebb and flow.......................8 Perspectives from different cultures.............................22 Being the bystander.............9 The truth about mental My masculinity..................10 health myths......................23 Baking to de-stress............11 Students’ experiences at the Counseling Center........12-13 Changes since the report on mental health.......................14 Mental Health is a special publication of The Johns Hopkins News-Letter, the student newspaper of Johns Hopkins University. For general inquiries or information on how to join, email managing@jhunewsletter.com.

The News-Letter can be found online at jhunewsletter.com, in print every Thursday during the school year and on the social media sites below.

2

JHU News-Letter The Johns Hopkins News-Letter

Mental Health

@jhunewsletter

@jhunewsletter

November 29, 2018

Self-care tips from The News-Letter editors I wake up at least an hour and a half before I have to leave in the morning; that way I have time to make breakfast and coffee/get caught up on work/scroll through social media. I’m always super relaxed and focused for the rest of the day.

- Alyssa Wooden, Managing Editor I paint my nails and watch Netflix. I physically can’t do most of my work with wet nails, so it forces me to take time off to just do something for myself.

- Amelia Isaacs, Arts & Entertainment Editor

Sometimes it helps to set everything down and stare into space for a few minutes. If I’m at home, I like to open the window, sit on my bed and focus on something aesthetically pleasing in my room, like my succulent, Luna. I’d listen to something instrumental to slow down my heart rate and breathing: Studio Ghibli soundtracks, Hilary Hahn’s Bach recordings, Schumann and the “Peaceful Piano” playlist on Spotify are always helpful. Afterward, I always feel more grounded, alert and focused.

- Sarah Y. Kim, Opinions Editor

Every Sunday night, I write up quotes of the week on the whiteboard in my room. They can range from wise words from Beyoncé to Aristotle. It helps set the tone for the rest of the week going forward and gives me some much-needed inspo in the moments when I’m feeling overwhelmed.

- Katherine Logan, Voices Editor

Some days I’ll take a hot bath and do a face mask and listen to Oprah’s Super Soul podcast or This American Life. Other days I’ll go for a run or make my favorite meal: chicken curry and rice.

Self care is taking a beat to think about what you most need in the moment and putting those needs at the top of your priority list.

- Morgan Ome, Editor-in-Chief

Half of feeling good is feeling like you look good. That’s why whenever I’m stressed I put a deep conditioner in my hair and a mask on my face. Not only do I come out of it feeling fresh, but it also forces me to set aside half an hour to let my mind relax.

- Samuel Farrar, Social Media Manager

When schoolwork has escalated to the point that it’s too much to handle, I rely on two things: a bag of Chex Mix and an episode of Friends. The Original and Turtle flavors are my favorites, and they always go well with the funny, reliable show.

I don’t recommend Hot & Spicy or any episodes with Joey/Rachel because they defeat the purpose of self-care.

- Ariella Shua, Your Weekend Editor

When I get stressed I buy a tub of ice cream on the way home from class, cancel all my plans and watch my favorite TV shows snuggled under my coziest blanket.

- Meagan Peoples, News & Features Editor

If I’ve ever had a rough day, my coping mechanism is eating bad takeout with my roommates, putting on a Disney movie and then accidentally falling asleep on the couch with the TV on.

Another thing I like to do is go to sports games and cheer all my frustrations away for just a little bit!

- Diva Parekh, News & Features Editor

When I am feeling overwhelmed by the amount of work I have to do or am particularly stressed by personal drama, I sometimes leave my phone in my room and head to Brody or the more aesthetic and calming Gilman. This lets me focus on what I need to accomplish by removing stressful distractions like text messages and social media. That way I can deal with my emotional shit later.

- Rudy Malcom, Magazine Editor

Whenever I’m feeling like I need to give myself some TLC, I put on a favorite vinyl on my record player, light a candle and write in my journal. It’s my favorite way to unwind at the end of a day. Growing up, writing has always been my favorite way for me to show myself love because it helps me process and work through my feelings and experiences. Setting the mood with music and candles while I do it also really makes me feel like I’m doing something extra special for myself.

- Kelsey Ko, Editor-in-Chief

I usually sacrifice a lot of sleep for work/extracurriculars, so listening to calming music and giving myself some time to catch up on sleep helps dissipate some of the stress.

For me, listening to music provides a temporary but much needed escape from obligations, deadlines and the generally fast pace of college life.

- Karen Wang, Magazine Editor

Whenever I feel frustrated or overwhelmed about things that are out of my control, I pick up my guitar and play my all-time favorite songs, or I go to the drum room in the Mattin Center and jam out. Playing the guitar and drums releases all the pent up feelings I have.

- Eda Incekara, Photography Editor

I like to read, binge watch YouTube and eat good food. Sometimes not restraining yourself and completely letting go is a healthy way to take care of your body! Sometimes I’ll take a trip to CharMar and reward myself with a tub of ice cream or grab a boba from T-Swirl. Indulging in things that may seem “bad” for you can sometimes help you too.

- Jeanne Lee, Cartoons Editor

Mental Health The Johns Hopkins News-Letter

November 29, 2018

3

The Mood Disorders Center: finding treatments for mental illness

By JAEMIE BENNETT Science & Technology Editor Ancient civilizations thought mental health disorders were the work of the gods — piss one of them off?

Here’s a mental illness. Today scientists understand these disorders much better, and the Mood Disorders Center at Hopkins is continuing to bring more knowledge to the table.

Mood disorders include depression and bipolar disorder, and can arise from illness or addiction. Anxiety is closely related to mood disorders as a common symptom.

The co-directors of A Place to Talk, senior Anna Koerner and junior Andrew Hellinger, agree that many college students face mental health disorders, especially at Hopkins.

“When you’re super busy in the middle of midterms, it’s very difficult to get to the gym; it’s very difficult to get that full seven to eight hours of sleep; it’s very difficult to make yourself nutritious meals... and those are very dangerous behaviors that are promoted by this culture of stress and competitiveness,” Hellinger said.

As about 10 percent of the adult U.S. population is diagnosed with mood disorders, they require proper understanding and treatment. The

4

Mood Disorders Center, within the Department of Psychiatry and Behavioral Sciences, has dedicated itself to this goal.

So far scientists cannot pinpoint a clear cause of mood disorders. The general understanding is that they are the rePUBLIC DOMAIN sult of an imbalance of chemicals known as neurotransmitters in the brain.

The Oxidative Stress and Mood Disorder Trajectories Research Study within the Mood Disorders Center, led

by Dr. Fernando Goes, aims to study images of the brain to understand mood disorders. They are searching for biological mechanisms to see what feeling “better” or “worse” looks like in a patient, and they hope to streamline intervention and prevention strategies in the future.

The causes of mood disorders may also be genetic. Koerner believes that understanding this could be beneficial in prevention.

“If you understand your genetic predisposition to it, that can help you be aware,” Koerner said. “‘Oh hey, depression runs in my family, this is something that I should be aware of and I should take more care of my mental health.’”

The Mood Disorders Center is creating databases to find those genetic links. The Family Genetic Studies of Bipolar Disorder project is collecting genomes from members of large families with bipolar disorder. A sector coined “Bioinformoodics” is compiling database servers, web applications and analytical tools for scientists to upload and share their findings.

The Johns Hopkins News-Letter

Understanding the causes of mood DNA to determine which drug will be disorders can tell scientists how and the most effective. The Center is also why someone is affected but not how participating in the National Network to help them improve. There are many of Depression Centers’ Mood Outpossible routes for treatment of mood comes Program, which aims to create disorders, including psychotherapy a standardized questionnaire to best and psychotropic drugs, which affect determine a patient’s mood disorder behavior. Both are commonly used to- and severity. It has also developed the gether, but the Mood Disorders Center mobile app MHi-Go, which is intendfocuses on psychotropic drugs such as ed to better keep patients on track and antidepressants and lithium. to provide more timely care.

Goes is also leading the Center’s Beyond research, the Center is participation in ketamine trials. Com- heavily involved in community outmonly used in emergency rooms as reach. Koerner and Hellinger agreed an anesthetic, studies since 2006 have that outreach and education are shown that ketamine has immediate weapons against mood disorders, effects on depression and bipolar dis- but with a caveat. order. Although high doses can cause “It’s a double-edged sword,” Kohallucinations, ketamine is hailed as erner said. “On one hand, it’s really one of the biggest breakthroughs in important to raise awareness and psychiatry. have people become aware that menKoerner and Hellinger believe that tal health disorders are legitimate... people are often hesitant to take medi- on the other hand, you don’t necescine for mental health disorders. sarily want people to be like ‘oh, I’m “There’s a stigma to it,” Koerner sad, therefore I have depression.’” said. “When people take medicine, However, the good seems to outthey think that there’s something weigh the bad. The Mood Disorders wrong with them.”

Center hosts the AnShe believes this stignual Mood Disorders ma may be why some Research/Educat ion “When people people don’t seek treatSymposium to spread ment. However, Koerner take medicine, awareness and knowllikened mental illness edge to physicians, scithey think to a physical disorder: entists, family members A patient may not want that there’s and patients. The Center treatment, but it’s the created the Adolessomething wrong also best course of action. cent Depression AwareWhile Hellinger be- with them.” ness Program (ADAP), lieves there is a stigma, aims to educate — Anna Koerner, which he hopes that scientific school-based profesAPPT Co-Director sionals, high school research can help.

“It really reduces the students and parents stigma if more people in about depression and the public begin to think of these ill- decrease the stigma surrounding it. nesses as actual diseases that are rootUltimately both Koerner and ed in biology,” Hellinger said.

Hellinger were glad to see Hopkins The Mood Disorders Center is at- devoting research to mood disorders. tempting to take its research one step “Especially at Hopkins, such a further by studying personalized large research university, the fact medicine. A clinical study is under- that they have a center focused on way to investigate GeneSight Psycho- this sort of legitimizes it, and I think tropic, a test that analyzes a patient’s that’s really powerful,” Koerner said.

Mental Health

November 29, 2018

Understanding the many complex causes behind mental disorders

By ALYSSA WOODEN Managing Editor

T

he question of what causes mental illnesses and disorders has been debated by doctors, researchers and psychologists for decades.

One of the most widely-accepted approaches to understanding the causes of mental illness is the biological approach. This is the assumption that mental illness is due to defective biological mechanisms, such as neural circuitry and biochemistry. Depression, for example, is thought to result from a deficiency in serotonin. Serotonin is a neurotransmitter, a chemical that passes between synapses in the brain, and is responsible for feelings of well-being and happiness. Today most prescription medications for depression are selective serotonin reuptake inhibitors (SSRIs), which block reabsorption of serotonin, thereby increasing its amount in the brain.

Similarly, psychotic disorders such as schizophrenia have been linked to abnormal release of dopamine, which regulates the brain’s reward center.

Antipsychotics work by blocking dopamine receptors.

However, neither antidepressants nor antipsychotics have been successful in treating the full range of symptoms related to their respective mental

illnesses, suggesting that there may be causes other than chemical imbalances. Researchers currently believe that depression and similar disorders are caused by a combination of genetics, psychological trauma, environmental stressors and chance combinations of personality traits.

Studies have shown that the risk of acquiring a mental illness increases if a family member has been diagnosed, indicating that there is a genetic component to mental illness. Although the stress of living with someone with a mental disorder may partially account for this risk, these findings have been replicated in adoption studies. For example, the prevalence of schizophrenia is significantly greater in individuals who have biological relatives with schizophrenia than in those who were adopted by people with the disorder.

Genes that code for proteins that regulate neurodevelopment may contain variations that alter the function of neural circuitry, resulting in mental illness. These dysfunctional genes can be passed on, leading to higher risk of illness in future generations.

Dr. James B. Potash, a researcher at the School of Medicine’s Mood Disorders Center, is part of a team

tom varco/cc by sa 3.0

that has identified over 40 genetic like stress or trauma also contribute variations for bipolar disorder, as to genetic disorders. well as a comparable number of These findings have been replivariations for depression. He ex- cated in animal studies. One study plained that genetics is only one of found higher rates of methylation many factors contributing to psy- of a gene associated with stress rechiatric disorders. sponse in rats who received high “It’s not the case that you have a levels of maternal care than in rats genetic variant and you will inevi- who received lower levels of care. tably get the disease,” Potash said. The adult offspring of the high-lev“Instead what it looks like is that el-maternal-care rats were less fearcombinations of genetic variations ful and had more modest responses seem to increase the likelihood that to stress than the rats raised by less you can get the illness, caring mothers. but it’s by no means deNotably, this meth“It’s not the case ylation was reversible; terministic.”

He elaborated that that you have a when researchers reenvironmental factors moved the methylation such as stress can play genetic variant in low-level-maternalan important role. care rats, their stress and you will “The thing that’s response returned to pretty clear cut cer- inevitably get the normal. tainly with depression disease.”

Despite the extenis that major stressful sive research, Potash life events increase the — James B. Potash, noted that there is no risk of depression,” he Researcher way to definitively said. “We think that prevent depression, althese major stressthough there are things ors interact with genetic variation individuals can do to reduce their in some way possibly through a risk. mechanism of epigenetics.”

“We know that broadly speaking, Epigenetics is the study of factors there’s some things that probably help that change gene activity without protect you. Probably a stable sleep changing the DNA sequence itself. schedule helps, not drinking to excess One example is DNA methylation, or using illicit drugs probably helps, which occurs when methyl groups exercise probably helps,” he said. are added to DNA. These changes In the future, Potash’s findings are reversible and are not necessar- may advance the field of pharmaily passed down to offspring. cogenetics, which involves using Specific epigenetic differences genetics to determine an effective have been found in the brains of course of treatment. people affected with schizophrenia, “Pharmacogenetics essentially bipolar disorder and major depres- means looking at genetic variasive disorder. Because the brains tions that might predict who’s goof suicide victims with depression ing to respond to particular antiwho had suffered abuse had higher depressant medications and who methylation rates than the brains of isn’t,” he said. “There’s a lot of talk those who had not suffered abuse, about that... companies are actually researchers have determined that marketing a number of tests to the this epigenetic response is triggered public, but the data is not strong by environmental stressors. This yet to clarify whether they really suggests that environmental factors work or not.”

Mental Health The Johns Hopkins News-Letter

November 29, 2018

5

Navigating dating and relationships with mental illness

By SARINA REDZINSKI For The News-Letter

I

usually don’t like to tell people I’m dating about my struggles with mental health for a couple of reasons. For one, it’s something that I’ve learned to cope with mostly on my own. With Obsessive Compulsive Disorder (OCD) and Attention-Deficit Disorder (ADD), difficulties mostly pop up on a brief, day-to-day basis, and I’ve adapted to handling small anxiety flare-ups and focus issues without too much help (though there is no downplaying the amount of help from family and friends I needed in order to get to this place of daily comfort with my disorders).

But more importantly, I don’t share these things with people I’m dating because it doesn’t usually get that serious. Very rarely do I connect with someone deeply enough and get to know them well enough to share those kinds of intensely personal details about myself. Typically, I’ll get a solid four-ish months of casually dating before I move onto someone new, which doesn’t leave me much time to divulge much about my disorders outside of the flippant “it’s an OCD thing” when asked about an odd quirk or habit I have.

For many people, being open about mental health in their romantic relationships can be an arduous

6

process. And I’ve found that to generally be the case for myself too. So, I figure, why go through all that just for someone I’ll only be dating for a little while anyway?

I don’t want the other person to view me differently or to pity me, and being vulnerable in that way after being mocked for it in the past can be scary, particularly because a lot of my symptoms are nonsensical and strange to anyone who doesn’t relate. Explaining why I have to spit a certain number of times while brushing my teeth before bed and why I always insist on wearing my socks inside out can be a real mood killer that I just don’t have the time for.

But then I started dating someone seriously for the first time, and I was faced with deciding how much of myself I really wanted to share with him. Feeling truly safe for what was essentially the first time, I slowly and carefully revealed little pieces of my symptoms when I felt I could. I’d mention things that made me anxious when they came up and explain how my ADD would sometimes send me veering the conversation in a totally un-

related direction (though he mentioned how he appreciated the way I’d try to veer it back on track once my tangent was over). I was starting to open up more than I had ever dared to before — though that isn’t saying much. It was scary, but I liked feeling as though someone genuinely wanted to know more about me.

Things turned sour pretty soon after that. It wasn’t necessarily anything to do with my mental health, but that certainly didn’t seem to help things.

I remember waiting with him for a D.C. subway train and gently tugging him away from the yellow line that delineated the area that was considered “too close” to the tracks to be safe. “Don’t stand there, it makes me nervous,” I told him.

His head snapped to look at me and, almost venomously, he said: “Everything makes you nervous.”

It was humiliating to be just standing there, surrounded by people, having my boyfriend use my anxieties as fuel for his anger at me. In that moment, I wished I had never told him anything. I swallowed embarrassed tears and con-

I was faced with deciding how much of myself I really wanted to share with him.

ceded, laughing weakly. “That’s fair,” I said.

Following that afternoon, I stopped trying to get him to understand what I was going through. After having a bad anxiety attack and feeling too unsafe with him to explain what had happened and why I hadn’t contacted him all day, I ended the relationship.

I’d like to tell you that once I broke up with him, I found someone who made the effort to make me feel loved and comfortable with my disorders, even when they weren’t easy. That would be a wonderful circular lesson to impart on you, that there is someone out there who will be able to accept all your weird and painful hangups and anxieties.

Unfortunately I can’t say from experience that that’s the case. I don’t yet know what it’s like to have that kind of deep trust in someone, to know that they won’t throw my symptoms back in my face or judge me when things get hard. Navigating relationships when you struggle with mental illness can be confusing and strange and potentially painful. But I’ve at least come to realize that if someone can’t handle these parts of me, then they don’t deserve any of me.

And if I didn’t find someone who could do all that, at least I learned that lesson.

PUBLIC DOMAIN

The Johns Hopkins News-Letter

Mental Health

November 29, 2018

Why I’m not going to forgive my abusers, and that’s okay

public domain

BY ZUBIA HASAN For The News-Letter

F

orgiveness is a complicated thing. It is touted as the one path to inner peace. Bitter people are never happy; angry people are never at peace. Accepting this was hard for me, because I am angry, and I am bitter, and I don’t think I want to let go of that.

I think my anger is what drives me, and some may say that is no way to live your life, but I think it has been the only way to live mine.

I am a relatively religious person. I may not pray so much, but I have a stubborn belief in God. And so it follows that I have a strong belief in justice. And be it the Bible or the Quran or the Torah or any other scripture that I am faintly acquainted with, forgiveness is touted as one of the qualities of God and thus one of the qualities that we as humans should aspire to.

And so being the relatively religious person I am, it didn’t seem like my choice of emotion was one particularly pleasing to God. But this didn’t bother me so much — I don’t think my god is so petty — but for those people who wanted to police my path to healing, the God excuse became a

legitimate way of downplaying my anger. And that’s why today I want to talk about why it’s OK to not forgive others for wronging you.

It’s funny how forgiveness has almost become the destination for all journeys to healing. It’s become commercialized and exploited to the extent that forgiveness loses its true meaning. It becomes a cover for abusers. Because if forgiveness is the end of all paths to healing then the act of abuse doesn’t really matter.

Survivors are supposed to wave a magic wand and erase their anger, hurt and betrayal, and if this is going to happen in the end anyway, then I don’t believe there is any system of accountability for abusers at all.

There is also the matter of what forgiveness is supposed to look like. I’ve heard from people about how there is this magical moment, this life-defining epiphany where I suddenly realize I can rise above the abuse and from then on I’m a

The Johns Hopkins News-Letter

changed person, a healed person.

That can’t be further from the truth.

Forgiveness is not this blanket statement; it’s not this umbrella that can hover above your life and protect you from all sorts of rain forever. It isn’t this yogi-like moment; it’s not a moment at all. It’s a constantly evolving, backtracking, sometimes changing thing.

There are times when I look back at my emotionally abusive relationship and I can forgive my ex because I feel sorry for him — how broken do you have to be to do that to another person? But there are other times — more times — when I am angry and rightfully angry.

Let’s get one thing straight: Forgiveness is a privilege, and those who want it have to earn it.

It’s sad that we as women are always expected to rise above. In a way, archaic beliefs about women compromising in relationships is a sugar-coated way of telling them to suffer. And women in abusive

I’m tired of fighting for my right to be angry, I’m tired of fighting for my right to be a person.

I’m not going to forgive because I don’t want to.

Mental Health

relationships are expected to suffer and forgive again and again — in return they are lauded by society as being better people.

Why does forgiveness make you a better person? Why does my rage make me a lesser person? This is the same idea that puts women on a moral pedestal that only serves to trap them. I’m tired of fighting for my right to be angry. I’m tired of fighting for my right to be a person. I’m not going to forgive because I don’t want to forgive. And that in itself should have been enough justification.

Wagatwe Wanjuki, a feminist activist and a survivor herself, talked about how there’s no need for her to forgive someone who isn’t even asking for her forgiveness, and I agree. Forgiveness is rare: It’s not something to be handed out to every which person. And it is also a choice which should be respected.

As for those who cite examples of God forgiving his people, there is only one caveat to that: He forgives those who repent with sincerity. My abusers have not — and even if they did I don’t have any obligation to forgive them.

For those who have truly forgiven their abusers, I am proud and happy for all of you. But for those who just can’t, don’t worry. There’s more where that came from.

November 29, 2018

7

Learning to balance the ebb and flow of mental illness growing up

PUBLIC DOMAIN

By LAURA OING For The News-Letter

A

sk anyone who knows me well and they’ll tell you that I love to talk, even to people I’ve just met. But I wasn’t always like this. Up until about my first year of high school, I was shy and stayed quiet around people who I didn’t know well enough.

The story of how I became less shy is most likely a combination of support from my family, encouragement from my teachers and just growing up and finding my voice. But in addition to all of these positive influences in my life, I began to struggle with my own mental health in a way that required me to seek serious help. I should probably mention that this article is purely based on my own personal experiences, and therefore what I say will not apply or be helpful to everyone.

I first experienced extreme sadness when I was in the fourth grade.

I would cry for nights in a row, and I would tell my parents about how it seemed the world would be better without me in it. Thanks to my parents’ understanding that there was something serious going on, I was sent to see my first therapist.

I have few memories of what we actually talked about together, but learning to open up to someone who wasn’t my direct family ended up being an extremely valuable skill. I hadn’t realized how much I

8

had been holding inside me, and I learned that it was okay to ask for help when needed.

Since fourth grade, I have continued to work to mitigate the symptoms of my disorders. When I was in eighth grade, I was diagnosed with obsessive-compulsive disorder (OCD), in addition to my depression (which decided to rear its ugly head once again).

It was then that I started taking daily medication, which helped immensely, but medication by itself was not enough. I had to go to even more intense therapy sessions. Because of the nature of OCD, these sessions included addressing my fears headon. It was difficult and painful, and I often wanted to quit. I reasoned that life wouldn’t be all that bad if I gave up trying to control and decrease my symptoms. This was not true, and I

The Johns Hopkins News-Letter

realized that I had to continue treatment if I wanted to get back my quality of life.

That was six years ago. Since then, my symptoms have been a constant ebb and flow. I’ve had to return to therapy every now and then to refresh my memory on how I can manage my symptoms in everyday life.

My dosage of medication has also gone up and down.

I’ve learned to live with the fact that mental health is something that fluctuates. But unlike physical health, sometimes you just can’t help this. I don’t know the exact science behind it, but some brains are just different than others, and no amount of yoga, meditation or healthy eating can fix that (though doing those things can help some people).

As for any advice I hope you can take away from me sharing my sto-

ry: I cannot stress enough the importance of getting help when you need it. Find a therapist that you click with, and stick with them. Accept your therapist’s advice and observations. If therapy isn’t an option for you — either because it is financially unrealistic for you or because you are not comfortable with talking to someone you just met — find a friend or a family member.

Find someone you can trust to be a non-judgmental listener, and open up to them at whatever rate you are comfortable with. Ask your doctor about options you might have for medication. There is nothing to be ashamed about when taking medication.

Take care of your physical health.

Exercise if you can, eat healthy and stay hydrated. Most of all, try your best to be patient with the progress.

I’ve been dealing with symptoms since I was nine years old. I’m now 20 and, though I’m very happy, I am nowhere near “perfect.”

That being said, I’m in a much better place than I was, and if I could go back in time, I would tell my nine-year-old and 13-year-old selves that there are ways to get better. It is possible to live without feeling like a constant burden. It is possible to live without being scared of everyone who looks at you on the street. It is possible, though it takes lots of time and practice and hard work. But I cannot stress enough how it is so worth it.

PUBLIC DOMAIN

Mental Health

November 29, 2018

Being a bystander: How can I help someone I know who is struggling?

By GABI SWISTARA For The News-Letter

T

he quick answer: It depends. It depends on the struggle. The enormity of this question paired with the spectrum of mental health issues, possibilities and struggles, makes this answer near impossible to tackle in a mere 1,000 words.

My experiences as an A Place to Talk (APTT) trainer, QPR-certified member, Sexual Assault Resource Unit (SARU) hotline respondent, psychology major and hospice volunteer will hopefully prove useful, though. I am going to break all the rules here and give advice (which is usually the worst thing you can do in supporting someone struggling with mental health).

In very broad strokes, most mental illnesses can be divided into two categories: ego-syntonic, like anorexia nervosa or narcissistic personality disorder, and ego-dystonic, like obsessive compulsive disorder (OCD) or major depressive disorder.

A person with the former believes it

is a good thing to have the disease; a person with the latter does not.

For example, people with anorexia — an ego-syntonic disorder — truly believe that they are fat and that restricting their diet is healthy. There is no one correct way to talk to people with eating disorders since it is such a broad spectrum; but, usually supporting them in eating (offering to eat together or cook for them) and exercising (telling them it’s okay to take a rest day) is helpful. Only in recovery can someone even say the words “I have an eating disorder,” and recovery alone can take years. Once they are in recovery, though, directly asking them what would be most helpful is best. Being the person that they can call in tears if they feel fat or just ate, to reassure them that food is good and they are not fat, is incredibly helpful. Make it known to them that you are there for them. If you are close to them, telling them that you love them, that you are here for them and giving them a big hug can go a long way.

If they are a survivor of trauma (intimate partner violence, rape, abuse and other trauma), then providing support is key. Tell them that it is not their fault; that they are in control of their steps moving forward,; that they are not alone; that you believe them; and that it took a lot of courage for them to tell you and that telling you is a big step. Reassure them of your willingness to help and check in with them. Be respectful by asking for permission before giving them a hug and reaffirm that whatever happened should not have. Finally, support whatever decision they make regarding reporting. Their power was taken away from them, so give it back: Ask them if they want to report, but understand that both options — reporting or not reporting — are 100 percent valid. If they need help in reporting or just want someone’s hand to hold, offer them your support upfront.

If they have made suicidal jokes or said “I wish I hadn’t been born,” “I’m a burden to everyone” or even “I’m going to kill myself,” then questioning is key. Ask them if they’ve ever thought of suicide. Yes, it is a extremely difficult question to ask, but it could save a life. It will not make them contemplate suicide if they have not already. If they have, ask them if they have a plan.

Again, this will not put ideas into their head. This is the best thing you can do.

Think of it this way: If you don’t know, you can’t stop them. If they have a plan or if they turn to you as a final cry for help, do not leave them alone until they are with a professional. At that point, you need a professional: You can call the Hopkins counseling center (available 24/7), a hotline, 911 or another resource, but make sure that you reach out with their knowledge and consent. Help them through the process of seeking help.

If they are struggling with anxiety, being respectful and calming is key.

Respect their boundaries and do not push them into doing things which make them anxious. Let them know that it is okay, that they are not alone and that they need to do what is best for them to feel safe. If they are having a panic attack — symptoms include pounding heart, shortness of breath, shaking, sweating — then helping them feel grounded can help. You can try a breathing exercise: Place your hands on chest and belly and breathe in for five seconds, hold for five seconds, then exhale for five seconds.

Do this with them a few times until they can breathe. You can also try a grounding exercise: Ask them to find five things they can see, four things they can touch, three things they can smell, two things they can hear and one thing they can taste. Have them recite these things back to you. Once they are calm, listen to them.

In general, being willing to listen and offering your support is the best

way to help someone struggling with mental health. You can even bluntly say, “I may not understand what you’re going through but I am here to support you. You are not alone. If you need someone to talk to, I am here to help as much as I can.” You will be surprised to see how much that means for someone struggling with mental health. You may be shocked to realize how rarely they hear those words.

People surprisingly often lack proper listening skills, which is a true indicator of empathy and care. Listening well means listening without judgement, interruption or providing advice. Rather, ask them good, openended questions (never ask “why” since it’s perceived as judgmental); allow for silence before you respond; nod along with them; and show concern. Do not tell them what they should be doing. There are never any “shoulds” when it comes to mental health: Never tell them “you should be better by now,” “you should not be feeling depressed” or anything of that nature. “Should” is one of the worst things you can say.

THE GETTY CENTER

Mental Health The Johns Hopkins News-Letter

November 29, 2018

9

It’s time to talk about the jug of water I’m balancing on my head

By JACOB TOOK Managing Editor

E

very single minute of every single day I feel like I’m walking around with a massive jug of scalding hot water balanced on my head.

I’m afraid to spill a little tiny bit of that water because the whole jug will start to fall and burn the people around me.

I don’t want to write this because I’m so afraid of letting any water spill.

I struggle to write this because even now I can feel it leaking over the edge of the jug. The older I get, the heavier it gets, and the more energy it takes me to hold it up. That being said, I’ve gotten pretty good over the years.

That scalding water is a roiling mass of emotions, not everyday feelings like happy and sad, but deeper impulses like furious aggression and lingering melancholy and passionate love and deeply-rooted unattachment and tense panic and complete serenity and untraceable agitation.

I have been taught these emotions exist inside all men. From a young age, I was taught that men are gruff, intense, tightly-coiled and, above all, emotionally distant because they hold everything in a jug above their heads to keep it from spilling out.

For a long time I didn’t know that the jug was even there, and scalding water

10

would just splash onto any bystanders. Eventually people learned that they would be burned if they were too close, so they backed away.

When new people came along, everyone around me would warn them not to get too close. That’s why I couldn’t make friends when I was younger.

It took me far too long to notice the water splashing. It took the people closest to me, the ones who endured burn after burn for years, finally getting fed up. When they turned to me and said, “No more!” I realized that I had to keep that scalding water from spilling.

At first, it was impossible for me to keep it up. As soon as I got distracted, I would lose control of the jug. Too late, I would realize that the boiling water was already splashing down. That lasted for about two years. I still slipped up all the time, but my arms got stronger and I got better at keeping the jug balanced. And a few people who cared enough took their chances staying closer to me.

When I started high school in a new district, I was surrounded by so many new people who didn’t know to avoid my jug of scalding water. Many of them got burned, but I quickly learned that there were some people I really wanted to keep close. For the first time, I really focused on holding the water up, and I got better more quickly.

That’s not to say I didn’t slip up. For the most part, I could keep it together during the school day, but if I was really upset about something or felt too confident or got too caught up in having fun, it was easy for me to lose control.

Still, more and more people came closer and I tried harder than ever to keep

The Johns Hopkins News-Letter

that scalding water from spilling until it started to become second nature to me.

By the time I got to college, keeping the jug balanced was almost easy. Half the time, I barely noticed that it was up there. For the most part, the people around me felt nothing but the occasional sizzling droplets.

These days, I know how to distance myself when I feel my grip slipping. I know how to give myself breaks when I can set the jug down. I can even leave it behind in my apartment when I go out, sometimes even for days at a time, but eventually I have to pick it back up.

I learned to hold the jug upright because that’s what men do. I learned that men’s emotions are too violent, too passionate, too overpowering to go unrestrained. I learned this from men who were around me; I learned this from movies and music; I learned this from my therapists; and I learned from watching people scream in rage when they were scalded by the water.

I learned by example. I was burned, burned really badly by men who couldn’t keep their jugs of scalding water balanced, or by men who didn’t even try. I saw it for myself when I was younger. I grew so attached to people that when they made me upset I lashed out and they were scalded, and I would become furious with myself and desperately mournful that I’d hurt them.

Nobody suggested that I stop carrying the jug. Instead, I was only told to hold it tighter to keep it from spilling. Everyone who ever told me to “man up” was really reminding me to grab ahold of that jug because it was spinning out of control. I know that it’s just my conception of what it means to

Mental Health

“be a man,” and that theoretically it should be easy to unlearn that and get rid of the jug of water. But it’s so natural to me to keep it balanced over my head at all times.

Occasionally a few drops slip out, but I’m almost too good at keeping it up. It’s almost like not enough spills out during the day, so by the time I get home the jug is overflowing. I’m scalded in a deluge of that aggression and melancholy and love and unattachment and panic and serenity and agitation and everything else. Oversaturated buzz words like “toxic masculinity” don’t even begin to describe how badly that water burns.

I’m so worried about spilling anything from that jug that it’s impossible for me to access anything inside. I can’t be emotionally vulnerable because I’ve learned through years that vulnerability lets the water spill out. I’m apprehensive of close attachments because I don’t want to grow careless with the jug. I dread change because I’m worried it will throw me off balance. And the scars I bear from the scalding I’ve taken constantly remind me to keep my grip firm.

I’m trying to unlearn the jug. I’m trying to teach myself that I shouldn’t bottle everything up until it spills over and burns everyone who is close. It’s not that I want to learn to stop carrying it; I don’t want this water to be so hot. I want to let it cool off, so that I can pour it out when I want to without hurting anyone because I know that feelings aren’t inherently harmful and are a healthy part of being a person.

But sometimes, when I’m frustrated, it feels like I will carry this jug of scalding water to my grave.

Oversaturated buzz words like “toxic masculinity” don’t even begin to describe how badly that water burns.

November 29, 2018

Finding relief in a cookie: How baking alleviates my stress

By KATHERINE LOGAN Voices Editor

T

he latest pop smash echoes through the room, shots of grapefruit-flavored vodka line the worn table and the scent of cinnamon wafts from a tray of snickerdoodles in the corner. One of these things is not like the others. What is a plate of freshly baked cookies doing at a college party?

When it comes to my baking, hit a wall on is due or the moun- tions, a clear path forward to the deit all starts with deciding what to tain of reading in front of me. sired outcome. From the outside lookmake. Nowadays with the interAt least once a week you will ing in, it might look like a mess, but net, there’s never a lack of options find me in my apartment getting it’s a mess that I can contain. available. my zen on. Around finals season I am most at peace when music is Often I’ll turn to a blog like “Joy you might find me “procrastibak- playing from my laptop, my hands the Baker” or “Sally’s Baking Addic- ing” a little more often. are covered in cocoa powder or butter, tion.” I’ll scroll through their recipe Throughout the year, but espe- and the oven is on preheat. indexes, choose a few options and cially during this chaotic period, It’s worth noting that baking is a then (occasionally) let friends and there’s joy in sharing the fruits of realm within which one’s creativity family have a say in the final choice. my labor with my friends, provid- can flourish.

That said, ing them with a little something Over the years baking has become when I’m home, sweet and, in the process, benefit- a cornerstone of my mental health, a there’s nothing ting their mental health as well as key way that I manage my anxieties like digging my own. and rid myself of stress. through my Who doesn’t love receiving a conI’ve also come to enjoy experimentmom’s cook- tainer of sweets for no reason? ing, customizing my go-to recipes unbook selection, Sometimes I make a simple til I’ve found the perfect combinations sitting down confection like brownies. Having of methods and ingredients. with a pile of made them more times than I can As my mom taught me, for inselections and count, it only takes an hour tops. stance, you can never have too much perusing them Other times I’ll make a multi- vanilla, so doubling the amount of vafor the perfect layered cake with separate fillings nilla extract in any recipe is a given. recipe to fulfill and frostings or a recipe that inBaking is my ideal hobby in that my current craving. volves yeast and takes hours. it allows my desire for order and the Additionally, the search for the My Type-A brain finds comfort fun of expressing myself to co-exist, required ingredients in the super- within the confines of a recipe. while also helping to alleviate my market can feel a bit like a treasure There are set inputs and instruc- stress. hunt, which breaks up the day.

Of course the kitchen is where the fun really starts.

Within those four walls, I am forced to devote my entire focus to the task in front of me, lest I accidentally turn the mixer a notch too high and send flour flying or abandon the pan in the oven, only for the dessert in question to burn.

I can’t afford to be thinking KIMBERLY VARDEMAN / CC BY 2.0 about when that paper I’ve Logan discusses how baking delicious desserts not only satisfies her sweet tooth but also serves to alleviate her stress levels.

I am most at peace when music is playing from my laptop, my hands are covered in cocoa powder... and the oven on preheat.

Well, I was raised in the realm of “bless your hearts” and “might coulds,” where you simply couldn’t show up to a soiree empty-handed lest you be considered inconsiderate.

Logically, this rule was as applicable to a dorm room as it was a neighbor’s pruned lawn.

While my friends were once surprised by my sweet offerings, my desserts have become a means of making their day a little less stressful and a staple of times spent together.

Yet, for me, baking is more than just a fun skill; it’s a form of meditation. Traditionally, meditation involves sitting silently, focusing on your breathing and striving to focus your mind on a phrase or a mantra, or simply allowing it time to rest when you’re not overwhelmed by a barrage of thoughts and images.

It’s fitting that the Latin word for “to ponder,” meditari, is the root of “meditation.”

Individuals’ reasons for meditating vary; some do it purely for the sake of relaxation, others as a spiritual practice.

Regardless, studies show that people who meditate have a greater ability to quell their racing thoughts, making them less distracted.

They also experience less stress and anxiety in their daily lives.

Mental Health The Johns Hopkins News-Letter

November 29, 2018

11

“I want to believe they’re trying their best”: students

By NATALIE WALLINGTON For The News-Letter Senior Art History and Archaeology major Casey lives with hearing loss and tinnitus caused by a traumatic event earlier in her life. During her sophomore year, she decided to book an appointment with the University’s Counseling Center to seek help in coping with her disability.

Casey spent her initial appointment at the Center explaining the event which led to her hearing loss and tinnitus, a process she characterized as emotionally taxing. However, she said her follow-up counseling meeting was “disappointing in ways I really can’t even begin to describe.”

Her therapist made recommendations which went against the advice of Casey’s other doctors and demonstrated a lack of basic understanding of the details from her initial appointment.

“She recommended me to my own audiologist, for the program that I had described in detail the meeting before,” Casey said.

Her counselor also referred her to group therapy, a medium which her doctors had specifically warned her against due to her tinnitus and posttraumatic stress. The doctors had told her that patients with these conditions tend to compound each others’ symptoms in group settings.

“I was very shocked that she was recommending this to me when I had been told just how unhealthy it would be,” Casey said.

Casey, who asked to be identified in this article only by her first name, is not alone in seeking out counseling services. Mental illness among students has taken on qualities of a national epidemic — while an estimated one in four students has a diagnosable mental illness, nearly half of these individuals never seek treatment for their conditions. In response, universities like Hopkins have created task forces, reallocated funding and updated their counseling systems. But in the case of some students like Casey, negative personal experiences lead to a decision to stop using university counseling services.

“The fact that I had put myself in this position to be very vulnerable and then she had completely not listened and misconstrued [meant] I did elect to not go back,” she said. “I experienced a very specific error with a person who didn’t listen and who took lightly how much their input on my experience would matter to me.”

Starting this semester, the Counseling Center has implemented a number of new policies to make it easier to access timely care. But while some patients described positive experiences and outcomes, many still find serious faults with the way the Counseling Center provides talk therapy and psychiatric medication to members of the Hopkins community.

12

The News-Letter conducted interviews with current and former patients of the Counseling Center.

Students had a wide variety of experiences and opinions on the University’s primary mental health resource. The pseudonyms used in this article (Hannah, Rachel and Nick) represent individuals who requested anonymity to protect their privacy.

According to Director Matthew Torres, many of the Center’s new policies are focused on reducing student wait times and expanding access to service.

“Many of our efforts this year, such as our drop-in first appointments and Chat with a Counselor program in Brody, are aimed at reducing barriers to access,” Torres wrote in an email to The News-Letter.

Senior Public Health major Taz Shah noted some Mixed opinions positive changes in her Counseling Center experience as a result of these new policies. She explained Senior Physics major Beatrice Lunthat she has both referred friends to sford-Poe recalled having positive exdrop-in appointment hours and seen periences during her time at the Counscheduling benefits for herself.

“The biggest seling Center. Lunsford-Poe sought “One thing that has helped me is help during her sophomore and junior thing that I have that my psychiatrist has doubled his years for test anxiety and felt that talk hours at the Counseling Center, so I heard my peers therapy was beneficial. have a lot more flexibility with him “In the end, the conversations I had say is that they’ve now,” she said. with the psychologist were good, and Torres emphasized that the Cenmy test anxiety is a lot better,” she said. felt like they were ter will also be flexible when moving Lunsford-Poe’s impression of her forward with policies that ensure its own treatment at the Counseling Cen- not heard.” availability to new patients. ter was echoed by another student, “It is true that we really struggled Rachel. Rachel wrote positively of her last Fall, and to a lesser degree in the experiences using the Center’s services as a fresh- Spring, to see students quickly enough,” Torres man in an email to The News-Letter. wrote. “But our new model is working well and we “The Counseling Center sessions definitely are prepared to make whatever adjustments might helped me work through the issue that was at the be necessary to stay on top of the situation.” forefront of my mind at the time, and that was affectMany of the Center’s new programs aim to faing my relationships at Hopkins,” she wrote. cilitate contact with new patients. However, its Both Lunsford-Poe and Rachel, however, had res- increased caseload has produced a pattern of lesservations about recommending the Counseling Cen- frequent appointments that negatively affects reter to others based on friends’ stories and the reputa- turning patients. tion of the Center in general.

Shah added that scheduling remains a challenge “I feel like people generally tend to have not the for returning students seeking more frequent aphighest opinion [of the Counseling Center],” Lun- pointments with their psychologists. This has led sford-Poe said. “They definitely think it could be her to explore the Counseling Center’s group therimproved, but at the same time they’re like, ‘You’re apy services. struggling! This is a resource that is here, but also I “I wasn’t able to see my therapist as often as we both personally didn’t like it, but you should go.’ I hear agreed I should probably be seeing someone, but it was that a lot.” impossible because of her caseload, so we used [group “Is the Counseling Center better than nothing? I’d therapy] as kind of way to fill in the gap and make sure hazard for the most part, yes, probably. But there’s I’m still checking in with someone,” she said. only so much it can do,” Rachel wrote.

Rachel echoed Shah’s experience, citing it as her Each student who spoke with The News-Letter reason for leaving the Counseling Center. repeated this sentiment in some form: While many “A session once every two weeks just isn’t sufsaw some benefits from their treatment, all were ficiently frequent to work through a complex of inaware of limitations on its services. tersecting problems, ones that reoccur and appear One such limitation was the large number of stu- at the forefront of daily thought,” Rachel wrote. “I dents that the Center attempts to accommodate at once. stopped using the Center’s services because once every two weeks was insufficient.”

Expanding access Tailoring treatment With a total staff of 31 and a patient load of 1,548 last year alone, the Counseling Center was frequentAnother aspect of the Counseling Center’s new polly described as “overwhelmed” and “understaffed” icies is a shift in scope of the services they offer, which by some students who The News-Letter interviewed. Torres explained in an email to The News-Letter.

The Johns Hopkins News-Letter

Mental Health

November 29, 2018

reflect on their experiences at the Counseling Center “We have shifted to a more goal-focused, solutionoriented approach in the counseling we offer, and the feedback from students is positive,” he wrote.

Torres provided The News-Letter with data collected from Aug. 31 to Oct. 15 which showed ratings in the mid 4s out of 5 in student satisfaction in categories such as wait time, follow-up plan and overall service.

Some students expressed skepticism, however, about the effectiveness of short-term treatments in a university setting. One student, Hannah, emphasized the need for both long-term and short-term therapy.

“You can’t just have a one-size-fits-all solution,” she said. “Let’s say that a student experiences the death of a parent. Are you going to deny that person long-term therapy?”

The Counseling Center’s current policy is to refer students in need of longer-term treatment to mental health resources outside the University. Some students argue, however, that the cost of outside treatment makes the Counseling Center the only viable option for many members of the Hopkins community.

“If this is an issue that, say, they’re not able to talk about with their parents or with whoever’s providing their healthcare coverage, then what are they supposed to do?” Hannah said. “They have nowhere to go.”

Torres responds that incidents in which cost poses an insurmountable barrier would be handled on a case-by-case basis.

“While the Counseling Center’s model emphasizes short-term counseling, we do our best to provide services to students who are in severe need for services but can’t afford services in the community, at least until suitable off-campus services can be arranged,” he wrote.

“Listen to students” While some students who spoke to The NewsLetter received long-term care from the Counseling Center, many noted that the Center is often unprepared to handle larger and more complex mental health issues in an empathetic and productive way.

Rachel expressed frustration with how the Center has worked with students with disabilities.

“It’s incredibly clear that the Counseling Center has failed many students — and failed them egregiously,” Rachel wrote. “The stories that have come from the disability community are especially moving and outraging in the lack of consideration, substantial care and a real engagement with these struggles.”

Other students recounted similar experiences to Casey’s, wherein counselors seemed not to properly listen to patients’ concerns. Several recalled that their answers on the Center’s introductory questionnaire disrupted the conversations they had with their therapist.

After struggling with depression, senior Neuro-

science major Nick found his treatment derailed by recommendations from the Counseling Center. He an overwhelming focus on one question response. emphasized that he had improved significantly dur“One of the questions [reads], ‘Have you ing his period on medical leave. thought of harming yourself or others?’ And I put “Somehow it got misconstrued that I wasn’t actu“a little” on there, and immediately the whole con- ally doing that great, and the counselor recommendversation went from ‘Are you depressed?’ to ‘Are ed, actually, that I was not reinstated,” Nick said. you going to hurt someone?’,” Nick said. “There “I actually got reinstated like a week before classes may have been something to talk about there, but started. It was horrible.” at the same time that wasn’t really what I was reDespite this, Nick said that he does not fully ally concerned about.” blame the Counseling Center itself for his negative Nick believes that the University’s priorities may experiences. have gotten in the way of the Counseling Center fo“They’re understaffed, they’re not that large, cusing on his more pressing concerns. there are a lot of students who are experiencing “I could tell their concern was... making sure they stuff, and the University is probably giving them weren’t going to have another statistic to talk about,” pressure as to things they need to focus on,” Nick he said. “But some of my depression never got ad- said. “So as frustrated as I am with them... I want to dressed, and [during] the spring of my junior year believe they’re trying their best regardless.” my depression got the better of me, some bad stuff Moving forward, Hannah emphasized that the happened and I ended up having to take a medical new policies being implemented at the Counseling leave from the University.”

Center should address the issues of insensitive treatHannah echoed Nick’s experience. After facing a ment that she, Nick and Casey all experienced. number of personal dilemmas, she approached the “Students want to feel like it’s accessible — not just Counseling Center over Intersession last year. in terms of being able to get appointments but also in Hannah is a survivor of sexual assault, a fact which terms of having their issues be heard,” she said. she chose to disclose on her intake questionnaire. She Casey echoed this sentiment, saying that the first quickly realized that this information drastically step to improving care is to be more conscientious shifted the focus of her counseling sessions. when listening to students.

“All they wanted to do is talk about the sexual “The biggest thing that I have heard my peers assault. I was being treated like a battered woman,” say is that they’ve felt like they were not heard,” she she said. “The way they were talking about it... was said. “I don’t share with people my experience often bringing back all of those negative emotions and because I know that I don’t want to dissuade people stuff that I had worked so hard to be done with. So I from seeking out help. When people ask about the ended up feeling worse walking out of there than I Counseling Center, I usually try to be as judicious as did when I walked in.” possible. But I do think it is important that we talk Hannah explained that she had already made about ways that our system fails us.” peace with her sexual assault and was disappointed that it had become a focal point of her therapy appointments. She was eventually able to resolve her personal issues on her own, but said that the Counseling Center made this process more difficult than it would have been had she not sought help at all.

Nick’s issues were eventually resolved in a similar way. Following his medical leave, he felt that his reinstatement process was comSHEFALI VIJAY/PHOTOGRAPHY EDITOR plicated by miscommunication and unhelpful Students expressed frustration that their therapists would shift the focus of sessions to other topics.

Mental Health The Johns Hopkins News-Letter

November 29, 2018

13

How has Hopkins made progress on the Mental Health Task Force?

By EMILY MCDONALD News & Features Editor

I

n 2016, student and faculty representatives from across the nine schools of Hopkins convened to discuss ways to improve mental health on campus. This spring, the Task Force on Student Mental Health and Well-being released a final report, which provided data and recommendations on the climate surrounding mental health at Hopkins.

Co-chair of the Task Force and Chair of the Department of Mental Health at the Bloomberg School of Public Health Daniele Fallin addressed some of the suggestions outlined in the report. She explained that suggestions fell under two categories: those concerned with improving the climate at Hopkins and those concerned with structural changes to mental health resources on campus, such as the Counseling Center.

Fallon believes that the climate at Bloomberg has changed since the report was released.

“There really has been a shift in climate towards more awareness, acceptance of the challenges of the student and the mental health consequences of this timing in life, and then also this timing in life coupled with the very stressful experience of being a student

14

at a rigorous university,” she said.

Since the release of the report, Bloomberg professors have also been encouraged to include information about mental health resources on syllabi and to provide accommodations for students who cannot attend class because of a conflicting appointment with a psychologist.

Fallin added that circulating statistics about the prevalence of mental illnesses at Hopkins helps faculty understand that mental health on campus is a serious concern and helps students understand that others are dealing with similar issues.

“It seems to me from talking to students that concrete data is also reassuring that you are not alone, that this is not an isolated thing, that you are not a rare event, that these are shared experiences even if they’re not always spoken aloud, and it has been able to break down some of that stigma and make it more okay to share your experiences,” she said.

Fallin also noted that the report showed LGBTQ students, students experiencing racism and students feeling isolated, felt less supported than others. She stressed the importance of providing resources for particularly vulnerable populations.

Andrew Hellinger, the co-director of A Place To Talk (APTT), a peer

listening service on campus, has also noticed changes surrounding mental health on campus after the release of the report. He explained that APTT, along with other student groups, collaborated to form a coalition which meets regularly to discuss ways to improve mental health and well-being on campus.

Hellinger noted some administrative changes since the Task Force, such as the opening of a new APTT room in Brody. He also explained that since the Task Force, there have been shorter wait times and walk-in appointments at the Counseling Center.

“We were really happy to hear this semester how the Counseling Center has walk-in hours, which we think makes it much more accessible to all students,” he said. “Those small changes in the infrastructure have already helped the students a lot.”

Anna Koerner, co-director of APTT, agreed that she has seen improvements in student attitudes toward mental health.

“It’s just really cool seeing how much mental health has become a hot topic just since last spring,” she said. “The only way to address these issues is to openly talk about them and decrease the stigma that’s associated with seeking help and talking

about mental health, and realizing that mental health is just as relevant and important as physical health.”

Madelynn Wellons, the president of Advocates for Disability Awareness (ADA), has worked to promote mental health on campus. She believes that the culture at Hopkins can have a negative impact on student well-being.

“There’s this culture of ‘well, I’m suffering more than you,’” she said.

“That culture is really, really negative, and it encourages people to be in Brody until God knows what hour in the morning, and so the academic pressures can lead to a lot of really bad issues with mental health.”

She explained that while she too appreciates changes such as the improvements to the Counseling Center, she would like to see the destigmatization of conversations surrounding mental health at Hopkins.

“We’re at a bit of a crossroads where our culture is negative when it comes to a lot of these things... but there’s also this rise in the selfcare community at Hopkins, and there are a lot of people speaking out,” she said. “We’re at this moment where we’ve really got to push our way through, out of the negative culture, or we’re going to get dragged back in if there’s not enough change.”

FILE PHOTO

The Johns Hopkins News-Letter

Mental Health

November 29, 2018

How Hopkins creates a culture of apathy toward mental health

PUBLIC DOMAIN

By CARMEN SCHAFER Copy Editor

I

f you ever have the chance to peruse the “Parents of Johns Hopkins University Students” Facebook page, you’ll see more than one post from a parent whose child has developed anxiety and depression during their time at Hopkins.

Granted, many such students likely struggled with these issues long before Hopkins exacerbated them, and they likely would have struggled elsewhere.

Personally my mental health worsened at Hopkins. That being said, there is no way of knowing whether my mental health would have improved, or at least been better, at a different institution. After all, the college transition can be tough for anyone, anywhere. So is it really fair to blame Hopkins for your mental health issues?

Rather than trying to absolve Hopkins of blame, the grim reality is that many students enrolled here do indeed struggle with mental health issues. Why is this so and how does Hopkins — irrespective of how other universities are screwing up — contribute?

And while I do not have all the an-

swers, I bring you my very best guess: This University might be particularly conducive to mental health issues because it harbors an unhealthy culture of excellence, a culture inseparable from if not synonymous with our culture of suffering: If you’re not overworked, you’re not working hard enough, and even if you are overworked, you could and should be working harder.

As a result, students are pushed past the point of caring about anything but the attainment of their goals, both short-term — grades, internships, extracurricular clout — and long-term, like admission to graduate school, a prosperous career, a comfortable retirement and an even comfier death.

“Tell me a little about yourself.”

When faced with this open-ended question, most of us would probably comb through our résumés and ramble on about our academic and career ambitions. Most of us would reduce ourselves to an elevator pitch

because that’s the mold we’ve been encouraged to fit into.

So what happens when you don’t fit into this mold? When you have neither a polished and perfected elevator pitch nor an acute sense of direction? What happens when who you are and what you do is not valued by whoever is lurking on your LinkedIn? And, furthermore, what happens when you feel as though you’re the only one who feels this way?

What happens when you feel alone?

Maybe you start to care too much.

Maybe you stop caring at all.

If you bothered to read your syllabi at any point this semester, you may have noticed that this year, many professors have introduced a new blurb to their University policy sections: “The University is aware that many students experience anxiety, depression and other emotional challenges. If you would like to speak to a professional counselor, please visit the campus Counseling Center. Information is

Students are pushed past the point of caring about anything but the attainment of their goals.

available on the Counseling Center website: https://studentaffairs.jhu.edu/ counselingcenter/.”

To summarize, Hopkins is aware that many students experience certain health issues that the University does not take as seriously as other health issues. Rather than burdening your professors with said issues, please save them for the understaffed, underfunded counseling center.

Although this may seem like a step in the right direction, requiring professors to copy and paste this blurb into their syllabi will not fix anything. A counseling center, in theory, may be able to “cure” individual cases, but a handful of mental health professionals cannot dissolve a culture that pushes students to be not only one-dimensional but also apathetic to all other dimensions of higher education.

We are not here to make friends.

We are not here to learn. We are here to graduate with a transcript and résumé that will allow us to level up.

We are all about the destination, never the journey. And if this is where you choose to sacrifice your fleeting youth, for what you’re sacrificing to be here, I’d argue that you should be able to enjoy both.

Mental Health The Johns Hopkins News-Letter

November 29, 2018

15

How the Calm app has helped me balance my life at Hopkins others.

Like any stereotypical Hopkins student, I was drawn to the program titled, “7 Days of Managing Stress.”

Each session takes around 15 minutes to complete and consists of COURTESY OF DIVA PAREKH breathing exerThe Calm app sends users reminders every morning to remain mindful. cises and body relaxation,

By KATY WILNER with the intent of focusing one’s News & Features Editor mind. The peaceful voiceover asks you to think deeply about the root very day at 7 a.m. my phone cause of stress in your life and tells lights up with a “mindful- you, for those 15 minutes, to simply ness reminder” from the let go.

Calm app. The daily mesIn reality, the Calm app works. sage, which serves as a re- The programs are intended for minder to complete a meditation, is amateur meditators, overwhelmed usually a cliché — for example, “You students and people seeking a way can’t stop the waves, but you can learn to release their to surf.” Despite stress without havthe triviality of the ing to leave their notification, it rerooms. minds me to log I remember the onto the Calm app first time I fell into and complete one a deep meditation. of its many guided It was a wondermeditations. ful, much-needed A subscription break from the to this app costs stress of writing $59.99 per month papers, working (or you can pay against deadlines $299.99 for a lifetime membership). and worrying about balancing my However, for Hopkins affiliates, social life. Falling into a deep medithe app is completely free. Once tation and coming out of it feeling I learned of the app’s typically like I can tackle my many obligasteep price, I had to try it to see tions beats many other stress rewhat some people choose to spend leases in my life (no, not including $299.99 on. sex or binge-watching The Office).

The first time I logged onto the The app helped me transition to app, I was almost overwhelmed by life at college in many other ways. the variety of guided meditations. One of the biggest issues I faced Topics include working on stress during freshman year was figuring management, focusing, happiness, out how to eat. Whereas my parents self-esteem, mindful eating, calm- warned me about gaining the infaing anxiety, deep sleep and many

E

It’s the time of our lives where we should be focused on the way we think... and what makes us happy.

16

The Johns Hopkins News-Letter

mous “freshman 15,” instead I lost Hopkins in the first place.

10 pounds that winter. My energy Of course, an app or meditalevel dropped, and I frequently tion is not intended as a substitute skipped classes because I couldn’t for proper therapy or taking prefind the motivation to go to. scribed medication.

Eventually I began listening to But it helps, and it is something the Calm app’s “Mindful Eating you can take into your own hands.

Series,” which helped me to un- I have days where I know I have a derstand the importance of think- thousand things I need to do, and ing about what I put into my body. I can’t find the motivation to get Although it was a slow process, I out of bed. Instead of telling myself gradually began to eat more meals to go back to sleep, leaving myself a day and rely less on caffeine. with 10 minutes to get ready for Although the Calm app is defi- class, I now see a reminder to log nitely something I can imagine my onto the Calm app. soul-cycling, green juice-drinking The quotations telling me to friends back home in Los Angeles “make time for what matters” are doing — not necessarily my Brody- silly but effective. They remind me bound peers — I would highly rec- to slow down, to live mindfully ommend students take advantage and with purpose. of this free offer.

My rationale is this: It’s the time of our lives where we should be focused on the way we think, what induces anxiety and what makes us happy. For many of us, this is also a period of change, as it’s the first time we’re living away from our parents, feeding ourselves and tackling an obscene amount of homework.

If we don’t take 15 minutes per day to check-in with ourselves, it is easy to lose track of personal goals and even the reaCOURTESY OF DIVA PAREKH son we came to For Katy Wilner, the Calm app helped with stress management and focus.

Mental Health

November 29, 2018

Growing up and learning to live with my evolving OCD

By DIVA PAREKH News & Features Editor

W

hen most TV shows or movies portray a character with obsessive-compulsive disorder (OCD), that character can usually be found washing their hands for 15 minutes straight or flipping a light switch on and off five times before leaving a room. And to most of the world, that’s what OCD is.

But there’s a different kind, a kind you can’t really see unless you’re inside my head — where everything has a place. My life and my memories are in those stacking cubes that freshmen buy at Bed, Bath & Beyond. Each cube is stacked perfectly on top of the other, each row and column perfectly aligned.

Everything I’ve been through, every jarring experience, every tiny little piece of trauma is compulsively shelved away. Sometimes I’ll pull a cube out and face what’s inside; try and process it all; make a little progress; and then I’ll push it back in. But it’s a fragile sense of order, and it’s all too easy to break.

Do you remember when you were seven and your parents broke a mug?

It wasn’t your favorite mug. It wasn’t particularly special. It was just a plain mug with nothing on it. But it just

fell one morning in the kitchen and crashed to the floor and shattered.

I’d come running, no matter where I was or what I was doing, and I’d start sobbing. No one really understood why, least of all me, but I just wouldn’t stop crying. My mom would bring out a mug exactly like that one from the back of the cabinet and replace the broken one. But something still hurt.

Thirteen years later, I think I finally understand why. The mug, you see, was part of my tiny six-yearold routine. And when it broke, the order in my tiny six-year-old brain crumbled, and I responded to that the only way I could.

Ten years later, I’m in high school.

Because of how ruthlessly cutthroat the culture at my high school was and how incredibly high the expectations on us were, my anxiety had spent the past few years growing a lot worse.

In high school, we used to have cumulative final exams every two years, and we’d have this thing called a “study leave” — a month to study for two years’ worth of material. We’d have zero contact

with the world outside our houses, because everyone else we knew would be home studying nonstop.

As for me, I would break down constantly. Every time I did, I’d start feeling like there was something crushing my head and getting hopelessly overwhelmed. My closet was filled with at least 15 giant binders and notebooks, and I’d sit on the floor in front of it and pull everything out and throw it all in a circle around me.

Three hours later, I would have rearranged my entire bedroom. At first, my mom would try to stop me. She’d try to explain to me that I was wasting my time and that I should focus on studying and she would take care of the mess I had just made on the floor.

But that would just make me hyperventilate more.

Eventually, she learned that it was a better idea to just leave me to it. Putting everything back on the shelves, piece by piece, I would start to feel like I was piecing myself back together. I’d calm down, I’d get back to work and then the next day it would happen again.

I stop functioning until I can fix my surroundings — and fix what fell apart in my mind.

My OCD is very strange. I don’t need to wash my hands for 15 minutes. I don’t need to flip the light switch five times. But when a friend accidentally stepped on a container of marinara sauce on the floor and it exploded on my laundry hamper, I shut down. I stayed up till 4 a.m. washing the hamper clean in the shower.

I couldn’t sleep, I couldn’t stop, I just had to make it go back to normal.

When things like this happen, all the stacking cubes in my mind lose their balance. It’s no longer as easy to just push them back in their place because I’ve forgotten where they’re supposed to be. And then I stop functioning until I can fix my surroundings — and fix what fell apart in my mind.

Over the years, I’ve gotten better at dealing with it. But it still lingers.

Writing this article, I noticed that my first few paragraphs were all exactly four lines long on my Google Doc. So as I continued, I made every paragraph four lines.

It looked perfect, and it eased my flaring anxiety for just a second — until I realized that the structure actually made no sense that way. The article wasn’t really flowing. Ideas were being broken up in weird ways.

So I fixed it. It doesn’t look as good anymore. It feels kind of imperfect.

But I hear sometimes things are better that way.

PUBLIC DOMAIN

Mental Health The Johns Hopkins News-Letter

November 29, 2018

17

What we miss by classifying autism as a mental illness can contribute to the conversation.

Even though my brother’s disability is obvious to me, the idea of autism being a mental illness is one that is hotly debated.

I wouldn’t guess that “mental illness” can be defined in just a few words, but according to the internet, it can. Psychiatry.org defines mental illnesses as “health conCOURTESY OF ARIELLA SHUA ditions involvAriella Shua, pictured with her younger brother Eitan, who has autism. ing changes in emotion, thinking or behavior

By ARIELLA SHUA (or a combination of these).” They Your Weekend Editor are also “associated with distress and/or problems functioning in soriting about mental cial, work or family activities.” health is a touchy According to this definition, my subject for me. brother’s form of autism would fall That’s not be- under this category. Eitan goes to cause I am dealing school every day, likes watching with anxiety, or depression or anoth- videos on YouTube, plays Wii Sports er form of mental illness myself. I am like an expert and has perfect pitch, extremely fortunate in that I don’t, to unlike all of the other musically my knowledge, have a mental health challenged members of my family. issue or disability.

But Eitan is also extremely chalHowever, one of my favorite peo- lenged in a lot of ways. He talks, but ple in the world has what I would he can’t have real, complete conversaclassify to be one. He’s my little tions longer than a few sentences (and brother, and he has autism. typically, even forming those sentencBefore the pitchforks come out, es coherently is a challenge). He reads, let me just say that I’m aware that but he generally won’t unless there I’m defining terms when I classify are pictures, the words are simple and autism as a mental illness. It is not a he’s being told to. He enjoys the outuniversal belief that autism falls un- side world, but he can’t leave the house der this category. A developmental without supervision, because he still disorder, yes. But is someone dealing doesn’t know to not trust strangers, with autism the same as someone and he often forgets to look both ways dealing with a mental health issue? before crossing the street, even though In general, when the topic of men- he’s almost a teenager. tal health comes up, I’m unsure if I All of these traits suggest a devel-

W

18

The Johns Hopkins News-Letter

opmental disorder, not a mental illness. But what about Eitan’s tendency to scream when he doesn’t get his way? What about his need for certain lights to be off and doors to be shut at all times? What about his inability to explain why he doesn’t like something, instead of throwing a tantrum more appropriate for a two-year-old than for a 12-year-old?

Don’t get me wrong; I love my brother, more than I can describe.

And people are amazing to him. Really, really amazing — he knows my sister’s and my friends from home, and they’re all sweet to him. He is loved by the administrators and “typical” students alike at all of the schools he’s attended. The stereotype of bullying the different kid — a worry that I’ve always had when it comes to Eitan going anywhere — has never manifested, at least not in a way that anyone close to him can tell.

I feel as though, on some level, people are afraid to classify autism as a mental health disorder because of the wide range of people who are on the autism spectrum. They are not all like my brother. A great many autistic people have the ability to fight for themselves against questionable causes, such as Autism Speaks, and to tell their own stories.

To those on the spectrum, I quite honestly say, all the power to you. Without you fighting for recognition and acceptance, perhaps Eitan would have fallen victim to those classic bullies, rather than being loved by his peers and mine.

I hesitate, too, to definitively call autism a true mental illness. It would suggest a need to change who Eitan is; it would suggest that autism is a health problem which needs to be fixed. I don’t want to think of my brother — or any of the others I know on the autism spectrum — as

Mental Health

needing to be fixed.

And yet, I hesitate to not call autism a mental illness. Eitan also has anxiety, obsessive-compulsive disorder (OCD) and a mild case of Tourette’s. Some of these are classified as mental illnesses, and it’s acceptable to treat them as such. I hate that my brother immediately worries about when we’ll go home as soon as we leave the house, and that for months he had a compulsive need to line our living room floor with 70 toy tractors, all in a specific order, all facing the same direction.

These traits can be downplayed with medicines and therapy, and the world accepts that it’s okay to do so, just as a depressed person may take anti-depressants to alleviate their symptoms. So why are my brother’s autistic tendencies not viewed in the same way? Not all of them, but the ones that make his life more difficult for those around him, and more importantly, for himself? Why is it controversial to admit that, in his case, he needs help?

Perhaps the most important part of the Psychiatry.org page on mental illness isn’t the definition it provides.

On the side of the page, in a font several times larger than the main text, are two clear, concise sentences in a standout shade of blue: “Mental illness is nothing to be ashamed of. It is a medical problem, just like heart disease or diabetes.”

Whether autism falls under the category of mental illness or not, I hope that we can all agree with this statement. Developmental disorders, mental disorders and autism spectrum disorder are nothing to be ashamed of. And all of them should be treated in the same way that any medical issue would — with respect and the best care possible.

Developmental disorders, mental disorders and autism spectrum disorder are nothing to be ashamed of.

November 29, 2018

It’s not all in your head: the brain and gut connection

F

By MORGAN OME Editor-in-Chief

or as long as I can remember, my stomach has always hurt. Sometimes, I would feel like I was being stabbed with a dull knife, over and over. Other times, my body would break out in a cold sweat from waves of nausea. Even when I wasn’t in pain, my stomach would make noises, prompting people to ask what was wrong. I usually just said that I was hungry, even if I wasn’t.

When I turned 17, I started experiencing panic attacks in school and was diagnosed with anxiety. I started going to therapy, but it wasn’t helping much, so my therapist recommended that I see a gastroenterologist to check out why I was having so many stomach aches.

“You need to get a colonoscopy,” the doctor said, to which I replied, “I don’t have time.”

Then the doctor said, “I don’t want to freak you out, but...,” which is possibly the least comforting thing a medical professional can say. She continued, “In the worst case scenario, you might have colon cancer.”

I panicked. We scheduled a date for the colonoscopy later that month.

As I drove myself back to school, I felt my stomach tighten, and I started to cry. Having bad stomach aches everyday was one thing, but cancer?

That was something I was entirely unprepared to hear.

Most people have their first colonoscopy around the age of 50, so I felt strange preparing for one in high school. In the days leading up to the procedure, I fasted and took laxatives.

When the results from my colonoscopy came back, I was expecting the worst. The doctor told me that I had lymphocytic colitis, a chronic inflammatory gut disease, which was treatable but not curable. She prescribed budesonide, which many patients with Crohn’s disease take to suppress their immune system.

The medicine would ensure that my body would not attack itself and

hopefully reduce the inflammation.

The doctor also gave me a list of foods that I couldn’t eat for the next four months. I was horrified. I couldn’t have anything acidic, like coffee, onions or tomatoes and no hearty vegetables like beans, broccoli or cabbage. I should avoid raw fruits and vegetables, limit my fiber intake, cut out dairy and stay away from sugars and carbs.

So for the next four months, I took my medication every day and ate a plain diet. It was pretty miserable. But my stomach aches went away, and so did my panic attacks. Because I followed the doctor’s instructions, I slowly was able to add foods back into my diet that I actually enjoyed eating. It’s been four years since I was officially diagnosed with colitis and anxiety, but it wasn’t until last month when I was scrolling through my Facebook feed that I realized there could be a direct connection between my stomach problems and my mental health issues. I came across an article that discussed several of the nerve pathways connecting the brain and the gut, and suddenly, a lot of my health problems made sense.

I spoke with Dr. Jay Pasricha, the director of the Hopkins Center for Neurogastroenterology, about the brain-gut connection. His research focuses on the enteric nervous system, which is located in the gastrointestinal tract and contains more than 100 million nerve cells. Since the brain and the gut have the same neurotransmitters, people with gut diseases, especially irritable bowel syndrome, often experience anxiety and depression at higher rates.

“If you look at prevalence rates of anxiety and depression with irritable bowel syndrome, it’s about 50 to 60 percent or higher, even with colitis and inflammatory bowel disease,” he said.

Pasricha explained that for many people, anxiety can manifest as a butterflies in the stomach feeling or as a need to go to the bathroom when they’re nervous. But symptoms of anxiety in the form of gut problems

are not necessarily the product of mental health issues. Sometimes, mental health problems can arise from gut diseases.

“If you talk to most gastroenterologists, they think of this as a topdown problem: You know, you’re anxious or stressed and that gives rise to bowel symptoms,” he said.

“The bottom line is it’s not all in your head. What’s happening in your head can actually start in your gut and vice versa.”

I wanted to better understand how I could use science to improve my own health so I contacted Calliope Holingue, a Ph.D candidate at the Bloomberg School of Public Health. She teaches the SOUL course Mental Health and the Gut (it’s also offered over Intersession) and researches the intersection between physical and mental health.

“One of the reasons I got into the field is that I also had both of those issues. It motivated me to understand that connection better,” she said.

Holingue explained that scientists have been trying to learn more about how the gut and brain influence each other since there is an obvious connection.

“We know that having a mental health issue creates stress in the body and leads to poorer physical

health. For example, people with depression are less likely to have good hygiene, a healthy diet and exercise,” she said. “When people have more physical issues, like pain, they tend to develop more mental health issues.”

Holingue also told me that having a healthy diet is one of the best ways to help one’s mental and physical health.

“The diet is arguably the factor that affects our gut health the most, and it’s the one we have the most influence over. A well-balanced diet with lots of different fruits and vegetables — those things will help us have a more diverse gut microbiota ecosystem,” she said. “It becomes a real challenge to find a diet that doesn’t exacerbate symptoms but also doesn’t create this unhealthy gut microbiome that is lacking in diversity.”

Understanding my own body has helped me immensely over the last month. There is no cure for colitis.

There is also no cure for anxiety.

They will be with me, to a greater or lesser degree, for the rest of my life.

But, thanks to discoveries in science and medicine, perhaps people living with chronic gut diseases or mental illness can arm themselves with better tools so that they can live fuller lives.

PUBLIC DOMAIN

Mental Health The Johns Hopkins News-Letter

November 29, 2018

19

[ Deleted ] Addy Perlman

For The News-Letter

I wrote a piece.

I was forced to throw it away, to delete it from my hard drive, to delete it from my mind.

One hard copy was all I had, but my tears made the ink bleed, just as the folds in my brain do when I’m told I have to censor myself.

What am I to say to the ones closest to me when I just want to heal, when I just want to accept, when I just want to forgive?

To know that they are the ones who told me: transcend. Transcend and one day you can reflect. You can share your story.

When is that day?

Do you have an answer of substance, an answer that is more than: when you don’t come back here anymore.

So am I to choose between myself and you?

In a Wonderworks house, flipped upside down, my feet tread along the ceiling as I rake through the thoughts flooding my head like quicksand.

Sinking me. Further and further.

I turn to you, but I’m faced with emptiness.

20

Photo By Shefali Vijay

The Johns Hopkins News-Letter

Mental Health

November 29, 2018

What mental health resources does Baltimore have to offer?

COURTESY OF MORGAN OME and EDA INCEKARA

Baltimore City residents comprise over 30 percent of patients discharged from hospitals for mental illness reasons in Maryland. Baltimore is only 11 percent of the state’s total population.

By JEANNE LEE Cartoons Editor

A

s students at Hopkins, we are all residents of Baltimore City. It is easy to forget this when we talk about mental health at Hopkins, an indisputably academically stressful environment, yet a privileged population. In some neighborhoods in Baltimore, mental health stems from deep-rooted issues of segregation, poverty and socioeconomic disparities.

In our attempts to combat mental health at our university, we subconsciously ignore mental health issues that affect communities outside of our campus. The Task Force on Student Mental Health and Well-Being, formed by students and faculty in 2016 to address mental health at Hopkins, highlighted the main triggers of mental illnesses for students in their February 2018 report. They listed the competitive academic culture and difficulty of adjusting to a new environment as the main culprits of stress. But these issues address a limited scope of triggers that could induce mental health problems.

Gun violence. Opioid addiction.

Domestic abuse. These issues, rather than academic stress or struggles in adjustment, are only a small number of a long list of triggers resulting in the high rates of mental illness in Baltimore. Baltimore residents comprise a large majority — over 30 percent — of patients discharged from hospitals for mental illness in Maryland, a concerning statistic considering the fact that Baltimore’s population is only 11 percent of the state’s total population. In 2016, Baltimore City reportedly had the highest rate of deaths caused by drug overdose amongst large metropolitan cities in the U.S., and these rates have continued to increase. It is also estimated that 60,000 Baltimoreans have a drug or alcohol addiction.

Even more striking is the state of mental health among Baltimore’s youth.

According to a 2013 report, 28 percent of students have experienced symptoms of mental illness. In addition, it is reported that a large percentage of children face many adversities, as they may have encountered domestic violence, experienced the death of a parent, lived in a house with drug addiction, or been a victim of or witness to violence.

These numbers reveal a harsh truth: that some of our neighbors, who live a

The Johns Hopkins News-Letter

few miles or even a few blocks away from Homewood Campus, might not have the same access to mental health resources and support that we do.

This is not to dismiss the efforts Hopkins has made to resolve mental health amongst its students, nor is it to undermine the recent wave of depression and anxiety claiming college students in recent years. Mental health issues are on the rise amongst college students around the U.S. Students in college account for a large proportion of the high suicide rate amongst adults aged 15 to 34, of which suicide is the second-leading cause of death.

However, it is difficult to deny that the Hopkins community is not as aware as it should be about Baltimore’s issues with mental health and inequality.

While we should continue to break the stigma against mental health, we also need to broaden the scope of people who are affected by it.

I had my moment of realization in a public health class, where my

Mental Health

only window to view the issues surrounding mental health in Baltimore was the PowerPoint lecture projected at the front of the room. Sitting comfortably in my seat, I realized the irony of learning about problems that were occurring directly outside the building in this way. The Hopkins community as a whole, both its instructors, students and myself, need some time for reflection.

As we continue to develop our own programs to fight mental health in an academic environment, we should also keep the Baltimore community in mind. As the Baltimore City Health Department continues to build many of its own programs, such as the Resiliency in Communities after Stress and Trauma (ReCAST) program and the Promoting Student Resilience program, our own Task Force should not forget our neighbors. Let’s continue to foster a healthy student community, but let’s also spread these efforts to Baltimore, the city we live in and love.

Our neighbors... might not have the same access to mental health resources and support that we do.

November 29, 2018

21

Perspectives on mental health around the world though one in five Indians will suffer from depression in their lifetime, only 10 percent will seek help.

By CLAIRE GOUDREAU For The News-Letter

T

he University’s undergraduate population boasts students from 62 different countries, with 11 percent of the current freshman class being international students. With this cultural diversity comes a mix of perspectives, cultures and experiences, especially in regard to mental health. In response to increased globalization over the last century, many countries have seen stigma against and support networks for the mentally ill change. Regardless, most cultures still have perspectives about mental illness that greatly reflect their regions’ traditions.

Argentina

Argentina has the highest number of psychologists per capita in the world. In Buenos Aires, there are 1,280 psychologists per 100,000 people, and that number is growing. For every student who graduates from a psychology program, 2.6 more enter. Their therapy of choice? Psychoanalysis. As a result, many residents report that there is reduced stigma surrounding seeking treatment for mental health issues.

China

China’s psychiatric system was dismantled after the Communist Party seized power in 1949. Since socialism was supposed to fi ll the people with enthusiasm and contentedness, those displaying symptoms of depression risked being seen as traitors. Because of this, few people were diagnosed until the 1990s. Today, over 100 million Chinese people live with a mental illness, but only six percent of them seek mental health treatment. China has only 1.7 psychiatrists (most of whom are not fully qualified) for every 100,000 people.

“The last generation, like my mom and my dad, think mental issues are a disease and don’t want to face it,” Chinese student Annie Gao said.

“Most of my classmates in China during the past 10 years have thought about committing suicide. Two years ago during the college entrance examination there was one boy who jumped from the second floor 30 minutes after the exam started. He didn’t die.”

Finland

According to the World Happiness Report, Finland is the world’s happiest country. It is also one of the many countries whose public health care offers the alternative of online therapy. Patients have access to computerassisted behavioral therapy for depression, alcoholism and anxiety and can message mental health professionals if needed. Although the practice has faced international skepticism, preliminary evidence suggests that the therapy works just as well as traditional face-to-face sessions.

India

In India, mental illness remains highly stigmatized. When asked their feelings about the mentally ill, 47 percent of Indians report feeling “judgement” and 26 percent report “fear.” Sixty percent of Indians believe mental illnesses are caused by a lack of self-discipline and willpower and believe that the mentally ill should have their own groups so they don’t “contaminate” others. According to the World Health Organization, even

22

The Johns Hopkins News-Letter

Indonesia

Although pasung (the practice of shackling and confi ning those with mental illness) was banned in 1977, it still remains a widespread practice in Indonesia. About 57,000 Indonesians have been shackled or locked in confi ned spaces as treatment for a perceived mental illness at least once.

Currently, an estimated 18,800 people are receiving this “treatment.”

Norway

Norway offers some of the most comprehensive mental health care in the world, with psychiatric casualty clinics (which also serve as mental health emergency rooms) and the option of medication-free treatment.

However, the system has fallen victim to abuse. In 2017 it was reported that at least 40 patients had received electroconvulsive (electroshock) therapy without their consent.

South Africa

Over half of mentally ill South Africans consult traditional or faith healers rather than therapists or psychologists. Those who do seek Western treatment through public mental health care take a gamble. In 2017 it was reported that at least 94 of the country’s mental health patients had died after being prematurely removed from public facilities and placed in community ones. Causes of death included dehydration, starvation, cold and general lack of care. Some died within days of the move.

The United States

Approximately one in five American adults experience mental illness in a given year, but only 41 percent of this subset have received mental health services in the past year.

These numbers are even worse for college-aged students, of whom one in four have been diagnosed with a mental illness. Thirty-one percent of college students have reported feeling so depressed in the past year that it was difficult to function, and more than 50 percent have reported feeling overwhelming anxiety. Mental illness is also a major reason for students dropping out of college, with 64 percent of college dropouts citing it as a leading cause.

Mental health has also become the forefront of recent political debates, with President Donald Trump responding to recent gun violence by saying that mass shootings are “a mental health problem at the highest level” and calling the Las Vegas shooter a “very sick man” and a “demented person.”

Vietnam

“There is almost zero consideration for mental health issues in Vietnam,” Vietnamese student Thế Anh Trần said. “Recently there have been student-led initiatives trying to get more awareness for mental health, but there’s lots of ignorance around the issues.”

A 2006 World Health Organization report found that the country had only 30 mental hospitals, with a total of 5,000 beds. Those in remote areas have less access to mental health resources.

Mental Health

November 29, 2018

Beyond the stereotypes: dispelling myths about mental illness

T

hose being effectively treated for psychotic illnesses are no more likely to be violent. Still, a 2006 survey found that 60 percent of people thought that those with schizophrenia were likely to act violently. Emma McGinty, deputy director for the Center for Mental Health and Addiction Policy Research at the Bloomberg School of Public Health, wrote in an email to The News-Letter

that this belief is not true.

“Only about four percent of all interpersonal violence is attributable to mental illness and the large majority of people with mental illness are never violent toward others,” she wrote.

“Only an estimated eight percent of people with mental illness who receive outpatient treatment ever conduct any act of violence, including minor acts like pushing or shoving.”

Center Assistant Director Alene

f course willpower is useful when living with a mental illness. It can affect whether you’re motivated enough to get out of bed, take a shower or eat a meal, but people often confuse mental illness with a lack of willpower.

McGinty emphasized the biological component of mental illness, as

disorders have both a biological component and behavioral component.

“Mental illness is a chronic and treatable health condition like diabetes,” McGinty wrote.

Despite high rates of mental illness in adult Americans, myths which delegitimize the experiences of those with mental illness contribute to an unwillingness to allocate

resources to treat these illnesses.

“Mental illnesses are health conditions. Framing these conditions as the fault of the individual is inaccurate, stigmatizing, and counterproductive. These attitudes are associated with reduced support for policies that increase public investment in mental health,” KennedyHendricks wrote.

Myth: People with mental illness can’t hold down a job

ccording to the National Alliance on Mental Illness, approximately one in five adult Americans experience mental illness each year. Many of these people hold jobs in high-stress environments.

“Serious mental illnesses like schizophrenia and bipolar disorder, which often onset during young adulthood, can result in employment chal-

lenges,” McGinty wrote. “However, early intervention with effective treatment greatly improves outcomes.”

A 2016 paper published in PubMed stated that disability policies and lack of funding are chief barriers to employment for those with mental illness. The paper suggests that an emphasis on early-intervention programs at the federal level may increase employment for

Kennedy-Hendricks also emphasized that recovery is possible for those with mental illness.

“Effective treatments exist for improving the health and wellbeing of individuals with mental illness. However, people with mental health and substance use disorders face significant barriers to accessing high-quality, evidence-based care,” she wrote.

It is often near impossible to tell

who lives with mental illness and who doesn’t. This has led some people to conclude that depression, anxiety or other disorders don’t exist. But it’s important to remember that they do exist and play a central role in the lives of some of our close friends and family.

Whether you have a mental illness or not, do what you can to stay educated about them and help reduce the stigma surrounding mental health.

By MEAGAN PEOPLES News & Features Editor

Myth: People with mental illnesses tend to be violent

O

M

cGinty likened the chronic nature of mental illness to diabetes.

“Mental illnesses are chronic health conditions. Many mental illnesses need to be managed over the course of a lifetime, similar to chronic conditions like diabetes, but with effective treatment they can be managed and controlled,” she wrote.

A

Kennedy-Hendricks wrote in an email to The News-Letter that media overemphasizes the link between mental illness and violence.

“People with mental illness are far more likely to be victims of violence,” she wrote. “Research has found that if excess risk of violence associated with mental illness was reduced to the population average, it would only reduce overall levels of violence in the US by about 4 percent.”

Myth: Mental illness is curable through willpower those with mental illnesses.

“People with various types of mental health conditions are valued, productive members of the workforce.

Individuals with more serious mental illnesses also often want to work and evidence-based supported employment programs can help participants obtain and sustain employment. Unfortunately, these programs are underfunded,” Kennedy-Hendricks wrote.

Myth: Mental illnesses can never be cured

Mental Health The Johns Hopkins News-Letter

November 29, 2018

23